Nowa wersja platformy, zawierająca wyłącznie zasoby pełnotekstowe, jest już dostępna.
Przejdź na


Preferencje help
Widoczny [Schowaj] Abstrakt
Liczba wyników
2013 | 8 | 5 | 548-552
Tytuł artykułu

Venous thromboembolism in pregnant woman - a challenge for the clinician

Treść / Zawartość
Warianty tytułu
Języki publikacji
Deep vein thrombosis and pulmonary embolism are two clinical entities of a single disease called venous thromboembolism. Venous thromboembolism is an important cause of maternal morbidity and mortality. Diagnosis and treatment of venous thromboembolism in pregnant women are much more difficult than in non-pregnant women. Pregnant patients were excluded from all major clinical trials investigating therapeutic combinations for acute thromboembolism. Although, for many years, the standard anticoagulant during pregnancy and postpartum was unfractionated heparin, current guidelines recommend low molecular weight heparin. The advantages of low molecular weight heparin are lower risk of bleeding, predictable pharmacokinetics, lower risk of fracture because of thrombocytopenia and heparin-induced osteoporosis.
Słowa kluczowe

Opis fizyczny
  • Internal Medicine Clinic, University of Medicine and Pharmacy Carol Davila, Clinical Emergency Hospital of Bucharest, Bucharest, Romania,
  • Internal Medicine Clinic, University of Medicine and Pharmacy Carol Davila, Clinical Emergency Hospital Sf. Ioan, Bucharest, Romania
  • Internal Medicine Clinic, University of Medicine and Pharmacy Carol Davila, Clinical Emergency Hospital of Bucharest, Bucharest, Romania
  • [1] Centre for Maternal and Child Enquiries (CMACE). Saving Mothers’ Lives. Reviewing maternal deaths to make motherhood safer: 2006–2008. BJOG 2011; 118(Suppl.), 1–203
  • [2] EUROPERISTAT Project, SCPE EUROCAT, EURONEOSTAT. European perinatal health report.
  • [3] Sullivan EA, Ford JB, Chambers G, Slaytor E. Maternal mortality in Australia, 1973–1996. Aust N Z J Obstet Gynaecol 2004; 44: 452–457[Crossref]
  • [4] James AH, Bushnell CD, Jamison MG, Myers ER. Incidence and risk factors for stroke in pregnancy and the puerperium. Obstet Gynecol. 2005; 106: 509–516[Crossref]
  • [5] James AH, Jamison MG, Biswas MS, Brancazio LR, Swamy GK, Myers ER. Acute myocardial infarction in pregnancy: a United States populationbased study. Circulation. 2006; 113: 1564–1571[Crossref]
  • [6] Heit JA, Kobbervig CE, James AH, Petterson TM, Bailey KR, Melton LJ. Trends in the incidence of venous thromboembolism during pregnancy or postpartum: a 30-year population-based study. Ann Intern Med. 2005; 143: 697–706[Crossref]
  • [7] Zotz RB, Gerhardt A, Scharf RE. Prediction, prevention and treatment of venous thromboembolic disease in pregnancy. Semin Thromb Hemost. 2003; 29(2):143–154[Crossref]
  • [8] Brill-Edwards P, Ginsberg JS, Gent M, et al. Safety of withholding heparin in pregnant women with a history of venous thromboembolism. Recurrence of Clot in This Pregnancy Study Group. N Engl J Med. 2000; 343: 1439–1444[Crossref]
  • [9] Pabinger I, Grafenhofer H, Kaider A, et al. Risk of pregnancy-associated recurrent venous thromboembolism in women with a history of venous thrombosis. J Thromb Haemost. 2005; 3: 949–954[Crossref]
  • [10] De Stefano V, Martinelli I, Rossi E, et al. The risk of recurrent venous thromboembolism in pregnancy and puerperium without antithrombotic prophylaxis. Br J Haematol. 2006; 135: 386–391[Crossref]
  • [11] Sanson BJ, Lensing AW, Prins MH, et al. Safety of low-molecular-weight heparin in pregnancy: a systematic review. Thromb Haemost. 1999; 81: 668–672 [Crossref]
  • [12] Lepercq J, Conard J, Borel-Derlon A, et al. Venous thromboembolism during pregnancy: a retrospective study of enoxaparin safety in 624 pregnancies. Bjog. 2001; 108: 1134–1140
  • [13] James AH, Jamison MG, Brancazio LR, Myers ER. Venous thromboembolism during pregnancy and the postpartum period: incidence, risk factors, and mortality. Am J Obstet Gynecol. 2006; 194: 1311–1315[Crossref]
  • [14] American College of Obstetricians and Gynecologists. Thromboembolism in pregnancy. ACOG Practice Bulletin No. 19. Obstet Gynecol. 2000; 96(2): 1–10
  • [15] Gherman RB, Goodwin TM, Leung B, Byrne JD, Hethumumi R, Montoro M. Incidence, clinical characteristics, and timing of objectively diagnosed venous thromboembolism during pregnancy. Obstet Gynecol. 1999; 94(5 pt 1): 730–734[Crossref]
  • [16] Qaseem A, Snow V, Barry P, et al, for the Joint American Academy of Family Physicians/American College of Physicians Panel on Deep Venous Thrombosis/Pulmonary Embolism. Current diagnosis of venous thromboembolism in primary care: a clinical practice guideline from the American Academy of Family Physicians and the American College of Physicians. Ann Intern Med. 2007; 146(6): 454–458[Crossref]
  • [17] Michiels JJ, Freyburger G, van der Graaf F, Janssen M, Oortwijn W, Van Beek E. Strategies for the safe and effective exclusion and diagnosis of deep vein thrombosis by the sequential use of clinical score, D-dimer testing, and compression ultrasonography. Semin Thromb Hemost. 2000; 26(6): 657–667[Crossref]
  • [18] Morse M. Establishing a normal range for D-dimer levels through pregnancy to aid in the diagnosis of pulmonary embolism and deep vein thrombosis. J Thromb Haemost. 2004; 2(7): 1202–1204[Crossref]
  • [19] Francalanci I, Comeglio P, Alessandrello Liotta A, et al. D-dimer plasma levels during normal pregnancy measured by specific ELISA. Int J Clin Lab Res. 1997; 27(1): 65–67[Crossref]
  • [20] Ginsberg JS, Hirsh J, Rainbow AJ, Coates G. Risks to the fetus of radiologic procedures used in the diagnosis of maternal venous thromboembolic disease. Thromb Haemost. 1989; 61:189–196
  • [21] Doll R, Wakefield R. Risk of childhood cancer from fetal radiation. Br J Radiol. 1997; 70:130–139
  • [22] Guyatt, G, Gutterman, D, Baumann, MH, et al. Grading strength of recommendations and quality of evidence in clinical guidelines: report from an American College of Physicians Task Force. Chest 2006; 129: 174–181[Crossref]
  • [23] Hall JG, Pauli RM, Wilson KM. Maternal and fetal sequelae of anticoagulants during pregnancy. Am J Med. 1980; 68: 122–140[Crossref]
  • [24] Kearon C, Kahn SR, Agnelli G, Goldhaber S, Raskob GE, Comerota AJ. Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008; 133:6 suppl: 454S–545S[Crossref]
Typ dokumentu
Identyfikator YADDA
JavaScript jest wyłączony w Twojej przeglądarce internetowej. Włącz go, a następnie odśwież stronę, aby móc w pełni z niej korzystać.